Retinoic Acid – A new target when treating hand osteoarthritis?

23 February 2023
Two people holding hands

New research has found that retinoic acid could play a key anti-inflammatory role in hand osteoarthritis. In the future, this could help us discover more life-changing drugs that tackle pain, stiffness, and disability.

Around 8.5 million people in the UK live with osteoarthritis, a condition which causes pain and stiffness in your joints, as well as fatigue. It can affect any joint in your body, but it’s common for the joints in hands to be affected.

Osteoarthritis (OA) is often dismissed as ‘a few aches or pains’, but it can have a profound impact affecting people’s ability to work, care for a family, or live independently.

It’s easy to underestimate just how often we use our hands. But when they're painful, stiff, or have poor grip strength due to osteoarthritis, everyday tasks (such as opening a jar, holding a pen, or doing up the buttons of your clothes) can become incredibly challenging.

Although there are ways to manage the symptoms of osteoarthritis, there are still no disease-modifying drugs that treat osteoarthritis. Disease-modifying drugs are drugs that change the way a condition progresses.

By discovering disease-modifying drugs, we could reduce symptoms such as pain and fatigue – and that’s exactly what this latest research hoped to discover.

What is osteoarthritis?

What did our research discover?

We want to better understand how and why osteoarthritis develops. That’s why we fund research at the Centre for Osteoarthritis Pathogenesis Versus Arthritis led by the University of Oxford.

This latest study looked at the importance of a molecule called all-trans retinoic acid (at-RA), which is made from vitamin A.

Here’s what the researchers found:

  • They confirmed previous research: that people who have severe hand osteoarthritis are more likely to have genetic changes, which affect how the body controls levels of all-trans retinoic acid (at-RA).
  • When examining the cartilage from individuals with hand osteoarthritis, they found that this genetic change led to low levels of at-RA, which was linked to increased inflammation in the cartilage. Inflammation in cartilage leads to the loss of its smooth surface thus removing its ability to protect the joint during activity.
  • They discovered that boosting the levels of all-trans retinoic acid (at-RA) was anti-inflammatory in the cartilage.
  • When a drug, which keeps levels of all-trans retinoic acid (at-RA) higher, was given to experimental models of osteoarthritis, the development of the condition was slowed down.

How will the findings benefit patients?

We urgently need treatments that could prevent or reverse the painful symptoms of osteoarthritis.

This research is still in its early stages, but it is promising because it gives us a deeper understanding of the causes of hand osteoarthritis and the drugs tested have been used for other conditions with a good safety record

A small proof-of-concept study is now underway, where the team will test whether the drug reduces cartilage inflammation in patients who are awaiting routine NHS surgery for hand osteoarthritis. If successful, a clinical trial could follow.

This brings us one step closer to developing a new class of disease-modifying drugs to treat osteoarthritis, prevent pain, and help people to live well with the condition.

How to get involved in our research

Our research partners and volunteers help us bring real-life perspectives to out research activities. 

Find out more about how you can help shape our research or participate in research studies on our website.

Get involved in our research

Get the support you need

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